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The oncologic role of local treatment in primary metastatic prostate cancer

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Abstract

Purpose

To determine the oncologic benefit or otherwise of local treatment of the prostate in patients with primary metastatic prostate cancer.

Methods

A review of the literature was performed in April 2014 using the Medline/PubMed database. Studies were identified using the search terms “prostate cancer,” “metastatic,” “metastasis,” “high risk,” “radiation therapy,” “radiotherapy” and “prostatectomy” from 1990 until April, 2014. Articles were also identified through searches of references of these articles.

Results

Retrospective series and population-based data suggest that the use of local treatment of the prostate in patients with primary metastatic prostate cancer may improve cancer-specific survival and overall survival compared with treating these patients with androgen deprivation therapy alone. The clinical outcome in metastatic prostate cancer is largely determined by the extent of lymph node involvement and overall metastatic burden. Contemporary data are lacking to recommend one alternative of local therapy (radiotherapy or radical prostatectomy) over the other. The primary limitation of this literature review is the lack of published randomized trial assessing the role of local treatment in addition to systemic therapy.

Conclusions

Local treatment appears to improve oncologic outcomes in metastatic prostate cancer patients. Nevertheless, due to the lack of high-quality evidence, its role needs to be confirmed in future prospective trials. The selection of ideal candidates and optimal treatment alternative (radiotherapy, radical prostatectomy or other) warrants further investigation.

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Conflict of interest

There is no conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany

    Pirus Ghadjar

  2. Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Hendrik Isbarn

  3. Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy

    Alberto Briganti

  4. Department of Radiology, Ghent University Hospital, Ghent, Belgium

    Peter J. L. De Visschere

  5. Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    Jurgen J. Fütterer

  6. Department of Urology, University of Udine, Udine, Italy

    Gianluca Giannarini

  7. Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, Ghent, Belgium

    Piet Ost

  8. Department of Urology, CHU Saint-Louis, Assistance Publique - Hôpitaux de Paris, Université Paris 7 Diderot, Paris, France

    Guillaume Ploussard

  9. Surgical Intervention Trials Unit, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK

    Prasanna Sooriakumaran

  10. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

    Prasanna Sooriakumaran

  11. Centre of Urological Surgery, Dialysis and Renal Transplantation, Fundeni Clinical Institute, Bucharest, Romania

    Christian I. Surcel

  12. Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    Inge M. van Oort

  13. Department of Urology, Rabin Medical Center - Beilinson, Petach-Tikva, Israel

    Ofer Yossepowitch

  14. Sackler Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel

    Ofer Yossepowitch

  15. Department of Urology, University Medical Centre Utrecht, Utrecht, The Netherlands

    Roderick C. N. van den Bergh

Authors
  1. Pirus Ghadjar
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  2. Alberto Briganti
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  3. Peter J. L. De Visschere
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  6. Hendrik Isbarn
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  7. Piet Ost
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  8. Prasanna Sooriakumaran
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  9. Christian I. Surcel
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  13. Guillaume Ploussard
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Corresponding author

Correspondence to Guillaume Ploussard.

Additional information

The authors are the members of the Prostate Cancer Working Group of the Young Academic Urologists Working Party of the European Association of Urology.

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Ghadjar, P., Briganti, A., De Visschere, P.J.L. et al. The oncologic role of local treatment in primary metastatic prostate cancer. World J Urol 33, 755–761 (2015). https://doi.org/10.1007/s00345-014-1347-9

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  • DOI: https://doi.org/10.1007/s00345-014-1347-9

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